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Stellate Ganglion Block
A stellate ganglion block (SGB) delivers local anesthetic directly to this nerve cluster, temporarily disrupting the overactive sympathetic signals that drive certain chronic pain conditions.
What is a Stellate Ganglion Block?
The stellate ganglion is a collection of sympathetic nerve cells located at the base of the neck, just in front of the spine. These nerves play a role in regulating pain signals, blood flow, and the body's stress response across the head, neck, arm, and chest. A stellate ganglion block (SGB) delivers local anesthetic directly to this nerve cluster, temporarily disrupting the overactive sympathetic signals that drive certain chronic pain conditions. At River Cities Interventional Pain Specialists, this procedure is performed under ultrasound or fluoroscopic guidance for precision and safety, and it is increasingly recognized not only for pain conditions but also for emerging applications in managing certain autonomic symptoms.
What To Expect
The procedure is typically performed in our clinic or at Park Plaza Surgical Specialists and takes approximately 20–30 minutes:
✔️ You'll lie on your back with your head slightly extended and the front of the neck will be cleaned and numbed.
✔️ Using ultrasound or fluoroscopic imaging, Dr. Brewer precisely advances a thin needle to the stellate ganglion, carefully navigating alongside the major neck structures.
✔️ A small volume of local anesthetic is injected adjacent to the nerve cluster.
✔️ Within minutes, you may notice warmth and flushing on the treated side of the face, a drooping eyelid (Horner's syndrome), and nasal congestion on that side — these are normal, temporary signs that the block was placed accurately.
✔️ You'll be monitored for 30–60 minutes before returning home.
Results and Recovery
The temporary effects of the block (eye drooping, facial warmth, hoarseness) typically resolve within hours as the anesthetic wears off. Voice hoarseness may last several hours — plan around this if you have speaking commitments. Most patients return to normal activities the following day. A series of blocks may be recommended for optimal results, particularly for conditions like Complex Regional Pain Syndrome. Our team will monitor your response closely and adjust your treatment plan accordingly.
WHO IS THIS BEST FOR?
Stellate ganglion blocks have demonstrated benefit for:
✔️ Complex Regional Pain Syndrome (CRPS) affecting the head, neck, arm, or hand
✔️ Hyperhidrosis (excessive sweating) of the face or arm
✔️ Vascular conditions limiting blood flow to the arm
✔️ Phantom limb pain following upper extremity amputation
✔️ Certain types of facial pain and headache syndromes with a sympathetic component
✔️ Post-COVID autonomic symptoms and certain hot flash conditions (emerging evidence)
Frequently Asked Questions
No. The Horner's syndrome (drooping eyelid, constricted pupil, and nasal congestion on one side) that may appear after a stellate ganglion block is a temporary and expected response. It indicates accurate block placement and fully resolves as the anesthetic wears off — typically within a few hours.
Yes, when performed by an experienced interventional pain specialist using imaging guidance. The neck is anatomically complex, and proper training and technique are essential. Dr. Brewer uses either ultrasound or fluoroscopic imaging to guide placement precisely, minimizing risk to surrounding structures.
For some conditions, a single block provides meaningful diagnostic or therapeutic benefit. For Complex Regional Pain Syndrome or other chronic sympathetically mediated pain, a series of 3–6 blocks is often most effective. Your response after the first block will guide the recommended treatment sequence.
Temporary voice hoarseness is a common side effect that occurs when the anesthetic spreads slightly to the recurrent laryngeal nerve. It is not permanent and resolves within several hours. We recommend avoiding important speaking engagements on the day of your procedure.
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